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Asymmetric Periflexural Exanthem of Childhood
A Clinical, Pathologic, and Epidemiologic Prospective Study
Didier Coustou, MD;
Christine Léauté-Labrèze, MD;
Paulette Bioulac-Sage, MD;
Laurence Labbé, MD;
Alain Taïeb, MD
Arch Dermatol. 1999;135:799-803.
Objective To assess the clinical, pathologic, and epidemiologic features of asymmetric periflexural exanthem of childhood (APEC), a clinically distinctive eruption, especially its link with pityriasis rosea and pattern of transmission.
Design A prospective case series, including an analysis of epidemiologic triggering factors and mode of transmission. Pathologic study, including immunohistochemistry of the inflammatory infiltrate.
Setting A mixed, community-based referral center.
Patients A total of 37 girls and 30 boys with typical APEC referred from April 1994 to December 1996 were included in the study; 82% came from the greater Bordeaux area in France.
Intervention None.
Main Outcome Measure Possible interhuman transmission of APEC.
Results No triggering factor was identified; no interhuman transmission occurred; and no demonstrable link with pityriasis rosea was apparent. Several new clinical variants were recognized or confirmed (high fever, facial and peripheral involvement, prolonged course). Distinctive perisudoral interface CD8+ infiltrate was suggestive of diagnosis.
Conclusions Interhuman transmission was doubtful, but inoculation disorder was still possible. Histopathologic findings seem more specific than previously thought.
From the Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-Enfants (Drs Coustou, Léauté-Labrèze, Labbé, and Taïeb); and Laboratoire d'Anatomie Pathologique et Cytopathologie Hôpital Pellegrin (Dr Bioulac-Sage), Bordeaux, France.
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